Manager, Charge Master

Title: Manager, Charge Master

Location: Fountain Valley / Pre-dominantly Remote

Department: Revenue Cycle Management

Status: Full Time

Shift: Day

Pay Range*: $135,782.40 - $203,694.40/annually

MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups – consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models.

Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation, and teamwork.

Position Summary

This position is responsible for the oversight of planning, conducting, evaluating and identifying proactive opportunities to strengthen the charging processes, enhance regulatory compliance and facilitate appropriate revenue capture for services rendered at all MHS facilities. Work involves providing expertise/guidance with respect to clinical documentation standards, billing guidelines and overall management practices as they relate to compliant organizational processes and standards related to charging and the charge structure within the various MHS charge description masters (CDMs).

Essential Functions And Responsibilities Of The Job

• Manage the MHS CDMs by coordinating with all MHS VATS and other department heads regarding the consolidation and creation of a common corporate CDM and charging practices.
• Manage all MHS CDMs to ensure coding and billing accuracy on new and existing service codes.
• Works with clinical directors and managers to implement and monitor CDM changes. Evaluates department requests to ensure that all additions changes and deletions are consistent with proper charging/coding practices.
• Works with clinical directors and managers to ensure the appropriate bundling or unbundling of charges so that all charges are submitted to result in maximum reimbursement while following applicable billing/reimbursement regulations.
• Manage the development of reports to monitor compliance with department recommendations.
• Work with billing personnel/nurse auditors in resolving third party payer billing problems.
• Works with the contracting department and third-party payers to resolve CDM related coding/billing problems.
• Works with Medicare intermediaries and MCS to clarify billing requirements and communicates this information to all applicable departments.
• Reviews all Medicare and Medicaid newsletters/updates. Performs periodic review of the MCS, and other payer websites to keep the MHS CDM up to date.
• Works with the Information Services Department to coordinate CDM changes on subsidiary systems.
• Works with the Corporate Compliance Review Committee regarding coding and billing compliance issues as related to the CDM.
• Manages the initiation and development of facility specific and regional models for financial analyses as related to requested and mandated changes to the CDM.
• Manages the development of reports to evaluate the effect on reimbursement of requested and mandated changes to the CDM.
• Manages the development, implementation and monitoring of CDM database systems, including Codecorrect and MedAssests, which enable corporate-wide management reporting on financial and operational data.
• Provide analyses for corporate level reimbursement projects.
• Manage the development of system wide policies and procedures related to the establishment, updating and maintenance of a common corporate CDM.
• Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare—that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there’s more...Check out our MemorialCare Benefits for more information about our Benefits and Rewards.